This document discusses a case study of a 13-year-old Hispanic female patient who was referred for weight management and abnormal lab results. She had a BMI of 31.97 (98th percentile for her age) and was diagnosed with obesity, hyperlipidemia, and elevated hemoglobin A1c. Her nutrition assessment revealed an unhealthy diet high in fried foods and sugar-sweetened beverages. The registered dietitian developed a nutrition intervention plan focused on reducing calories, increasing physical activity, and setting behavior change goals.
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Previously known as ‘failure to thrive’ (FTT), also known as weight faltering
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Can occur in both infants (< 1 year of age) and in children (> 1 year of age)
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Management of Anarexia nervosa
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Previously known as ‘failure to thrive’ (FTT), also known as weight faltering
Infant or children whose current weight or rate of weight gain is significantly below that expected of similar children of the same age, sex and ethnicity
Can occur in both infants (< 1 year of age) and in children (> 1 year of age)
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Review the clinical effects of formula in infants with CMA
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Types of Anarexia nervosa
Symptoms of Anarexia nervosa
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definition of malnutrition, the definition of protein-energy malnutrition , the etiology 0f protein-energy malnutrition, the pathophysiology of malnutrition, features of marasmus, features of kwashiorkor, vitamins and micronutrient deficiencies, signs of micronutrients deficiency, diagnosis, management of malnutrition,prognosis of malnutrition ,prevention of malnutrition
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A case Presentation on Lactic Acidosis, Hyperammonemia & Vitamin D Defficiency
Mehrima Binte Hasan, hailing from a village of Cumilla presents with- complains of development delay, behavioral problems. According to her parents, she was well stable after birth until before two years. In past two years, she is being less responsive to others gradually. In addition, she is not physically growing like other kids, which concerns her parents.
Age: 7y 3m
Height: 114 cm (Less height for Age)
Weight: 16 kg (Less weight for Height)
EBW: 19.4 kg
Improving the lives of those suffering from psychiatric and behavioral disorders is what we strive to achieve at the CNS Center of Arizona. Our psychiatrists specialize in severe and dual neuropsychiatric disorders. They understand and care for the patient medically, emotionally, socially, and spiritually. They teach what they know to patients and their families. This approach, we have found, helps empower patients to manage their lives, over time, and achieve the best outcome possible. Our approach at CNS Center of Arizona is a collaborative model of care involving other professionals and therapists. We expect patients who are currently in therapy to maintain contact with their primary therapist. CNS Center AZ
http://www.cnscenteraz.com
Severe acute malnutrition
NELSON 2016 BASED LECTURE
BY
DR. AL HUSSEIN RAGAB ZAKY
Luxor International Hospital,EGYPT
Tel: 00201113033672-00201012727282
Facebook : Al Hussein Ragab
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
definition of malnutrition, the definition of protein-energy malnutrition , the etiology 0f protein-energy malnutrition, the pathophysiology of malnutrition, features of marasmus, features of kwashiorkor, vitamins and micronutrient deficiencies, signs of micronutrients deficiency, diagnosis, management of malnutrition,prognosis of malnutrition ,prevention of malnutrition
Distinguish IgE and non-IgE mediated aspects of cow’s milk allergy (CMA)
Review the clinical effects of extensively hydrolyzed formula in infants with CMA
Lactic Acidosis, Hyperammonemia & Vitamin D Defficiency Nabila Kabir
A case Presentation on Lactic Acidosis, Hyperammonemia & Vitamin D Defficiency
Mehrima Binte Hasan, hailing from a village of Cumilla presents with- complains of development delay, behavioral problems. According to her parents, she was well stable after birth until before two years. In past two years, she is being less responsive to others gradually. In addition, she is not physically growing like other kids, which concerns her parents.
Age: 7y 3m
Height: 114 cm (Less height for Age)
Weight: 16 kg (Less weight for Height)
EBW: 19.4 kg
Improving the lives of those suffering from psychiatric and behavioral disorders is what we strive to achieve at the CNS Center of Arizona. Our psychiatrists specialize in severe and dual neuropsychiatric disorders. They understand and care for the patient medically, emotionally, socially, and spiritually. They teach what they know to patients and their families. This approach, we have found, helps empower patients to manage their lives, over time, and achieve the best outcome possible. Our approach at CNS Center of Arizona is a collaborative model of care involving other professionals and therapists. We expect patients who are currently in therapy to maintain contact with their primary therapist. CNS Center AZ
http://www.cnscenteraz.com
Severe acute malnutrition
NELSON 2016 BASED LECTURE
BY
DR. AL HUSSEIN RAGAB ZAKY
Luxor International Hospital,EGYPT
Tel: 00201113033672-00201012727282
Facebook : Al Hussein Ragab
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
Legislative Developments in the Aviation Sector in 2010Michal
The Polish Aviation Law (in Polish: Prawo Lotnicze; hereafter, PL) of 3 July
2002 was amended only once in 2009. The amendment was introduced by the
Act on the amendment of the Act on the Provision of services on the territory of
the Republic of Poland of 4 March 20101, which entered into force on 10 April
2010. Accordingly, two new provisions were introduced into Polish aviation law:
sub-article 1a was inserted into the existing Article 160 PL and a new Article 160a
was created. Both insertions specify that the Act on the Provision of services on
the territory of the Republic of Poland does not apply to its Aviation Law.
Eating Disorder In Teens M Jacob 2008 Mda TestMelanieJacob
Promising approaches in the treatment of eating disorders.
This presentation was done at the Michigan Dietetics Association meeting to an audience of registered dietitians.
Assignment 2-Health, Sport, Physical Activity in Australiaghanra02
A brief presentation on health in Australia, focusing on primary school children's health.
All animated and notes should be down in the slide notes section.
Childhood obesity is a serious public health problem globally. The prevalence of obesity among youth has been increasing steadily. Children who are overweight or obese are likely to stay obese into adulthood and are at risk to develop obesity related serious health problems including early puberty, insulin resistance, Type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, fatty liver disease, high cholesterol and orthopedic issues. These complications may lead early death. Also youth with overweight or obesity are at risk to develop psychological diseases such as depression, poor body image, eating disorder, and behavioral and learning disorders.
Prepared for community outreach presentations at Community Memorial Healthcenter (South Hill, VA) and Lunenburg County Middle School (Victoria, VA) 2008
Service providers who receive high nutrition risk referrals, particularly Registered Dietitians, need to be knowledgeable about general and clinical pediatric nutrition as well as counselling skills for working with families and children.
This is the second of five self-directed training modules available in PowerPoint presentations that have been developed and evaluated to respond to this need
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Dr. Zeina AlWahab, M.D.
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Increasing Fruit and Vegetable Intake andDecreasing Fat and .docxjaggernaoma
Increasing Fruit and Vegetable Intake and
Decreasing Fat and Sugar Intake in Families at
Risk for Childhood Obesity
Leonard H. Epstein, Constance C. Gordy, Hollie A. Raynor, Marlene Beddome, Colleen K. Kilanowski, and
Rocco Paluch
Abstract
EPSTEIN, LEONARD H., CONSTANCE C. GORDY,
HOLLIE A. RAYNOR, MARLENE BEDDOME,
COLLEEN K. KILANOWSKI, AND ROCCO PALUCH.
Increasing fruit and vegetable intake and decreasing fat and
sugar intake in families at risk for childhood obesity.Obes
Res.2001;9:171–178.
Objective:The goal of this study was to evaluate the effect
of a parent-focused behavioral intervention on parent and
child eating changes and on percentage of overweight
changes in families that contain at least one obese parent
and a non-obese child.
Research Methods and Procedures:Families with obese
parents and non-obese children were randomized to
groups in which parents were provided a comprehensive
behavioral weight-control program and were encouraged
to increase fruit and vegetable intake or decrease intake
of high-fat/high-sugar foods. Child materials targeted the
same dietary changes as their parents without caloric
restriction.
Results:Changes over 1 year showed that treatment influ-
enced targeted parent and child fruit and vegetable intake
and high-fat/high-sugar intake, with the Increase Fruit and
Vegetable group also decreasing their consumption of
high-fat/high-sugar foods. Parents in the increased fruit and
vegetable group showed significantly greater decreases in
percentage of overweight than parents in the decreased
high-fat/high-sugar group.
Discussion:These results suggest that focusing on increas-
ing intake of healthy foods may be a useful approach for
nutritional change in obese parents and their children.
Key words: fruits, vegetables, pediatric, prevention
Introduction
The prevalence of obesity in children (1) is increasing.
Although pediatric treatment has been relatively successful,
many treated children also regain weight during follow-up
(2). Given difficulties in changing established eating and
exercise behaviors, research is needed to prevent obesity
during development. Primary prevention may involve mod-
ifying intake and/or increasing expenditure, but the biggest
effect on energy balance will come from modifying intake,
because research suggests that obese and non-obese chil-
dren have similar activity levels (3,4).
Most dietary approaches for obesity treatment or preven-
tion attempt to limit intake of high-fat, low-nutrient dense
foods. This may be perceived as a dietary restriction by
people who find these foods reinforcing. The perceived
restriction can lead to increases in preference for these foods
(5), thereby increasing the probability of relapsing to pre-
vious eating habits when structured interventions are re-
moved. An alternative approach would be to teach children
to increase intake of healthy high-nutrient dense foods, such
as fruits and vegetables, which has been the target of large
public health in.
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Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
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This document is designed as an introductory to medical students,nursing students,midwives or other healthcare trainees to improve their understanding about how health system in Sri Lanka cares children health.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
ALKAMAGIC PLAN 1350.pdf plan based of door to door delivery of alkaline water...rowala30
Alka magic plan 1350 -we deliver alkaline water at your door step and you can make handsome money by referral programme
we also help and provide systematic guideline to setup 1000 lph alkaline water plant
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
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Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
2. OBJECTIVES
Discuss pediatric obesity epidemic
Utilize ADIME in a pediatric weight management intervention
Review the RD’s role in pediatric obesity treatment
Discuss the importance of motivational interviewing
3. CHILDHOOD OBESITY EPIDEMIC
There is an association between the rising prevalence of childhood
obesity and a corresponding increase in:
Diabetes Mellitus
Hypertension
Dyslipidemia
Nonalcoholic fatty liver disease
Hypertension
Cardiovascular disease
Joint pain and muscle/skeletal discomfort
Social and psychological problems
Breathing problems
http://guardianlv.com/wp-content/uploads/2014/02/Childhood-Obesity-Determining-Factors-Examined-in-New-England-Study1.jpeg
11. FOOD AND NUTRITION RELATED HISTORY
Mother does not cook regularly at home
Healthy foods such as vegetables are not readily available in the home
Dad purchases meals from fast food restaurants up to 3 times per week
Admits to eating large portions
Consumes candy, sweets, chocolates
Drinks a lot of soda and sweetened beverages
Family eats fried foods at home
Eats fruit/vegetables only sometimes
Not very physically active
12. PERTINENT LABS FROM 2/29/16
Total Cholesterol 142
TG 91 H
HDL 46
VLDL 18
LDL 79 H
13. 24 HOUR RECALL
Breakfast 7:00 am 1 plate of white rice and
meatballs with Kool-Aid
Lunch 12:00 pm School lunch: 5 chicken
nuggets, fruit cup and
chocolate milk
Snack 3:30 pm One bowl of Fruit Loops
cereal with 2% milk
Dinner 9:00-9:30 pm
After waking from an
unintentional nap
Fruit Loops cereal with 2%
milk
One plate of white rice
14. PHYSICAL ACTIVITY
Soccer Team on Thursdays from 3:30-5 pm
No PE class this school year
Per Father, does not like to engage in activities with him
and sister when asked
Screen time: 1 hour of phone usage (10-11 pm)
16. DIAGNOSIS
(NC 3.3) Obesity, pediatric related to self-
monitoring difficulty, excessive energy
intake, physical inactivity as evidenced by BMI
of ~32 and BMI-for-age in the 98%
percentile.
17. POSSIBLE BARRIERS TO WEIGHT MANAGEMENT
Family:
Lack of support from entire family
Food choices purchased for the home
Lack of family role modeling
Mother does not cook regularly/healthy foods at home
Father purchases fast foods up to 3 times per week due to convenience
School
Less healthy school meals
eating behaviors of peers
Individual characteristics:
Patient stuck in unhealthy routine
Not motivated to be active
18. SISTER VS. SISTER
G.D
13 years old, Obese
Vitamin D deficiency
Elevated LDL, TG, and HbA1c
Not motivated to be active
Large portions
PA once a week for 1.5 hours
Consumes fried food purchased by
dad
Eats out regularly with friends
K.D
11 years old, Overweight
Vitamin D deficiency
Elevated total cholesterol, LDL
Enjoys physical activity
Large portions
Consumes fast food purchased by
dad
Motivated to make lifestyle changes
20. ESTIMATED ENERGY REQUIREMENTS
MSJ: -161 + 10 (60.7 kg) + 6.25 (161.4 cm)- 5 (13 y.o) = 1403
kcals/d
1403 kcals x AF 1.3 (Ambulatory)= 1800 kcals/d
EER for Sedentary (13 years old) ~1500 kcals IBW used
Protein: 0.95g x 83.3 kg = 79 g/d
DRI for 9-13 years old and ABW used
Fluid:1500 ml + [(83 kg-20 kg)] x 20= 2,760 ml/d
Holiday Segar Method and ABW used
21. NUTRITION COUNSELING APPROACHES
Multidisciplinary treatment of pediatric obesity
Nutrition Assessment – 24hr recall + suggestions for change
Tailor behavior intervention to Stages of Change
Motivational Interviewing w/ RD
Self- Monitoring
Goal Setting
Diet intervention
Allow the client to choose or suggest the behavior change
23. HANDOUTS
Low carb snacks
Healthy breakfast options
List of low sugar foods
High fiber cereals
MyPlate method
Goal sheet
24. GOAL SETTING
1. Will only drink water and white, low fat milk at home
2. Will eat a healthy option for breakfast every morning
3. Choose fresh fruit and vegetable sides for lunch at school and in between
meals
4. Limit eating out/fast food to only one meal per week still choosing only
water to drink
5. Increase exercise to 1 hour of walking to and from the park and being
active while there
6. No naps after school, find ways to be active instead
25. MOTIVATION TO CHANGE ON A SCALE FROM
1-10
10 !!!!!!!!!!!!!!
https://doctormarialuque.files.wordpress.com/2014/11/bigstock-
diverse-hands-holding-the-word-64516201.jpg
29. REFERENCES
Michalsky M.P, Inge T.H, Simmons M, Jenkins T.M, Buncher R, Helmrath M, Brandt M.L, Harmon C.M,
Courcoulas A, Chen M, Horlick M, Daniels S.R, Urbina E.M. Cardiovascular Risk Factors in Severly Obese
Adolescents. JAMA Pediatrics. 2015; 169 (5): 438-444.
The N.S, Suchindran C, North K.E, Popkin B.M, Larsen P.G. Association of Adolescent Obesity with risk of severe
obesity in adulthood. JAMA. 2010; 304 (18): 2042-2047.
Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary treatment of pediatric obesity: nutrition
evaluation and management. Nutr Clin Pract. 2010;25(4):327-34.
Academy of Nutrition and Dietetics (n.d.). Overweight and Obesity. Retrieved May 2nd, 2016 from
https://www.nutritioncaremanual.org/topic.cfm?ncm_category_id=1&ncm_toc_id=16997&ncm_heading=Nutrit
ion Care&ncm_content_id=79432#DiagnosticTests.
Center for Disease Control and Prevention. Prevalence of Childhood Obesity in the US. Retrieved May 3rd, 2016
from http://www.cdc.gov/obesity/data/childhood.html.
Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary treatment of pediatric obesity: nutrition
evaluation and management. Nutr Clin Pract. 2010;25(4):327-34.
Editor's Notes
IBW of 60.7 kg using 83.3 kg/m2 at the 85%ile BMI/age
Be ready to discuss the implications of all abnormal labs
Indicate energy factor used.
Protein needs are calculated using ABW
Mention the emphasis of family-wide change
Will f/u of labs only if repeat is available from PMD since RD cannot order them. Abnormal labs usually repeated every 6 months